Provider Demographics
NPI:1659500841
Name:KAKAR MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:KAKAR MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANDITA
Authorized Official - Middle Name:RANI
Authorized Official - Last Name:KAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-544-7131
Mailing Address - Street 1:PO BOX 15062
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92735-0062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1506 BROOKHOLLOW DR
Practice Address - Street 2:# 128
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5405
Practice Address - Country:US
Practice Address - Phone:562-544-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9550207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty